The School of Health and Human Sciences
PLEASE PASS THIS FORM TO YOUR IDENTIFIED SUPERVISOR FOR COMPLETION
Becoming a Supervisor for Mentorship Preparation (HS601/605/614)
I am pleased that you are prepared to become a Supervisor for a mentor/clinical educator on the Mentorship
Programme at the University of Essex. In order to be a Supervisor you must be a qualified Mentor on a live mentor
register.
Please complete the attached form, have it verified by either your Line Manager or Education
Liaison Manager and return it to the address at the bottom of the form as soon as possible.
Your role as a supervisor
You are responsible for:
 Meeting with the student regularly throughout the module to talk about how the module content can be applied to
where you both work. This will include establishing and completing learning contracts.
 Working with the student on two or more occasions when they are practising teaching and assessing in the
workplace. This may include countersigning the practice assessments of other learners.
 Undertake and record an assessment of the student on at least one occasion. As a Supervisor you may have
concerns about the fitness of a student to become a mentor. If so it is important that you contact me as soon as
possible so we can arrange to give you and your student the necessary support to determine whether they should
pass or fail the module.
The role of the mentor/clinical educator that you are supervising
The student is responsible for:
 Identifying his/her own learning needs
 Arranging meetings with you and also with his/her academic supervisor
 Actively identifying learning opportunities and practicing relevant skills
 Attending/engaging with taught components module
 Meeting the requirements of the module assessment
 Accessing relevant module e-learning resources
The role of the module lead
The Module Lead is responsible for the delivery and quality assurance of the module. This involves:
 Maintaining communication with students, supervisors and others associated with the module
 Being available, and responding, to problems associated with the module raised by students and supervisors
 Monitoring and improve inter-reliability between supervisors
 Overseeing the assessment process and monitoring feedback
 Monitoring student attendance and performance
 Providing feedback to all those involved in module delivery including supervisors as appropriate
As a Supervisor you should be familiar with the NMC Standards to support learning and assessment in practice
(Nursing & Midwifery Council 2008). These standards explain in detail what is expected of a mentor. This document
can be accessed at the following web link:
http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-to-support-learning-assessment.pdf
The role of the Supervisor is an essential component of Mentorship Preparation. Because of this your details will be
retained by the School and you may be invited to talk with the NMC and other bodies about how you have fulfilled this
role during any review of this module. As requested above, please complete the attached form, have it verified
by your organisation’s Education Liaison Manager or your Line Manager, and return it to the address shown
at the bottom of the form as soon as possible. Please do not hesitate to contact me if you are experiencing
problems or have any questions.
Yours sincerely,
Chris Green
Mentorship Preparation Lead
T 01702 328373 E cmgreeb@essex.ac.uk
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Mentorship Preparation Supervisor Details
Supervisor’s Details
Name
Position
Trust/Organisation
Contact address
Telephone
Email
Supervisor’s mentor/clinical educator qualification
When did you qualify as a
mentor*
Where did you study to
become a mentor*
Date and location of most
recent Mentorship update
attended
I wish to become a Supervisor for a student on the Mentorship Preparation module at the University of Essex. I have
read the attached letter and understand what this role requires of me.
Supervisor’s Signature: ……………………………………………………
Date: …………………
Supervisor Name (block capitals please):
…………………………………………………………………….
Name of mentor you will be supervising (block capitals please):
………………………………………………..
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TO BE COMPLETED BY
THE LINE MANAGER OR EDUCATION LIAISON MANAGER
I certify that the above named person is fit to become a Supervisor for the Mentorship Preparation module at
the University of Essex
Name of Trust or other Employer
Signed:
Education Liaison Manager/Line Manager (please circle)
Print:
Date:
Please remove the letter attached to this form and retain for your information.
Please return the completed form to:
Colchester cohort
Harlow, Broomfield and Southend
Carly Mitchell
Administrator (Mentorship)
School of Health and Human Sciences
University of Essex
Wivenhoe Park,
Colchester
Essex CO4 3SQ
Lizzie Norris and Lin Renahan
Administrators (Mentorship)
School of Health and Human Sciences
University of Essex
Elmer Approach,
Southend on Sea
Essex SS1 1LW
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